Practicing Medical Skills in a Small Clinic

Chapter 318 - 173: Commendable Diagnosis, No Unreasonable Hurdles

During the surgery, was the blood vessel damaged, causing thrombosis?

It’s possible, but it doesn’t quite match the symptoms like the high fever.

The surgical site is on the lower limb, and there are not many reasons for a sudden high fever.

A wound infection leading to sepsis usually takes several days, or even longer.

Li Jingsheng was deep in thought, feeling that his knowledge and experience were still insufficient.

"Right, could the subconjunctival bruise just be a coincidence?"

The subconjunctival bruise is a good breakthrough point.

The most common causes of subconjunctival bruises are sepsis, gonococcal conjunctivitis, and subacute infectious endocarditis, most of which can be ruled out.

Li Jingsheng’s level in cardiovascular medicine diagnostics wasn’t high, but he had some insights into diagnosing infectious endocarditis.

At this time, Director Hua and others had already discussed a result.

"Considering that the patient has certain purulent changes at the tibial head and joint connection, despite debridement, septicemia remains a suspect."

Many of the patient’s symptoms indeed match sepsis highly.

With the contributing factors, Director Hua and others almost unanimously supported this diagnostic conclusion.

Not long ago, Li Jingsheng had just grasped the discipline of dermatologic immunology, gaining deeper insights and understanding into immunology.

Moreover, he had a certain level in cardiovascular medicine diagnostics.

The foundation in General Surgery diagnostics was also solid.

All these are closely related to the infectious diseases department.

He thought the likelihood of sepsis is very small for the patient.

The time frame shouldn’t be this short.

Of course, it cannot be ruled out that the patient had sepsis before the surgery.

But this possibility can also be ruled out.

Didn’t they conduct pre-surgical examinations?

Unless the Second Hospital is just a facade, with major management issues.

If it were really that bad, it wouldn’t survive until now.

So, the possibility of sepsis is basically ruled out.

"Miss, could you please check the patient’s armpit to see if there are any bruises?"

Li Jingsheng looked at the ward nurse.

It would have been better to address her as a certain teacher, but since Li Jingsheng wasn’t familiar with her and didn’t even know her name, he addressed her as Miss.

Nowadays, addressing young women as Miss has become a generic term.

"Sure."

She nodded in agreement.

But from her indifferent expression, she seemed to think Li Jingsheng was making a fuss.

The chief doctors have already discussed a diagnosis result, why is a resident like you fiddling around?

Showing off?

After examining the patient, she exclaimed, "There are a lot of bruises on the left armpit." Then, she checked the right side.

"What about the right side?"

Director Hua asked eagerly.

Obviously, it’s a major discovery.

Considering the patient is a woman, no one had thought of checking her armpits.

"There are also plenty of bruises on the right armpit."

This result made everyone look at Li Jingsheng in a new light.

Director Hua, Professor Wu, and others started to rethink the possible causes of the patient’s condition.

After learning about the bruises in the patient’s armpits, Li Jingsheng immediately thought of a possibility.

"It’s fat embolism, that’s very likely it!"

Although he had a diagnostic result, what caused the fat embolism?

Without sorting out the pathological mechanism, Li Jingsheng didn’t dare to hastily draw a conclusion.

"Director Hua, I suggest we immediately perform a urine test and complete blood count on the patient, focusing on checking for fat globules. It’d be best to have the ventilator ready and prepared, the patient’s lungs should be experiencing severe edema, and the condition is progressing rapidly, I’m afraid by then... it might be a scramble."

Li Jingsheng phrased it more tactfully this time.

"Xiaoli actually suggested this earlier, and I felt it wasn’t necessary yet, so I didn’t accept it."

Professor Wu possibly worried about losing face, so he explained.

After all, now even a fool could see, this new doctor, Li Jingsheng, is quite extraordinary.

Even though he hadn’t voiced a diagnostic conclusion, suggesting tests on urine and blood for fat globules clearly indicated he had reached a diagnosis.

And it’s definitely not sepsis.

Furthermore, Li Jingsheng accurately hit the mark when asking about changes in the patient’s urine volume, and about armpit bruises.

This level of analytical and judgment capability was enough to outshine the likes of Dr. Ruan Xiaoqin present.

Even Professor Wu felt inferior.

Now, the orthopedic doctor’s office was nearly emptied as everyone without pressing clinical duties came over.

Director Hua was commanding the rescue on-site, and everyone wanted to come and show their skills, or at least learn some rescue experience.

After all, critical rescue cases in orthopedics are inherently rare.

Ou Qinglan, already fair and beautiful, looked even more striking in a white coat. Standing there, she was like a beautiful scenery.

Seeing Li Jingsheng on his first day at work performing like a seasoned warrior, even overshadowing the two chief doctors present, she couldn’t help but be dazzled by him.

This is the man she admires.

Unflinching in the face of danger, wise and brave facing critical cases, with a strong medical knowledge, performing exceptionally.

He was truly outstanding.

Xiao Jing felt a twinge of envy, more so shock. He hadn’t expected this new Dr. Li was not only skilled in bone-setting but also so adept at diagnosis.

Dr. Qin was the most frustrated.

He had already publicly declared his intention to compete with Li Jingsheng to win over the beautiful Ou Qinglan.